Chronic knee pain can make life quite difficult, as anyone who suffers from it will tell you. Activities that most of us take for granted, like walking up and down stairs or carrying groceries from the car into the house, become challenging and painful. As many as 20 percent of Americans over age 50 suffer from chronic knee pain, which is most often caused by osteoarthritis or degenerative joint disease.
While knee replacement or arthroscopic surgery can be a solution for some patients, it is not an option for many others, who may have been deemed too young, too old, too overweight or who have other complicating medical conditions. These patients must rely on more conservative treatments like physical therapy, oral anti-inflammatories or knee joint injections, and these are not always successful at making a meaningful difference. In addition, 10 to 30 percent of patients continue to experience long-term pain even after knee replacement surgery.
Now, relief is in sight for tens of thousands who thought they had to live with this chronic pain. A relatively new technique called genicular nerve radiofrequency ablation can offer significant reduction of chronic knee pain via a fairly simple outpatient procedure.
This minimally invasive procedure involves the placement of needles that direct heat to specific nerves involved in knee pain, blocking their ability to send pain signals to the brain. The effects can last from six to 18 months, and the procedure can be repeated when necessary.
Before the treatment can be done, the doctor will need to perform a diagnostic procedure to determine the potential effectiveness of the radiofrequency ablation. A specific group of nerves will be targeted, under X-ray guidance, with needles. A small amount of numbing medicine will be injected around the nerves. Patients who experience 50 percent relief or better are considered good candidates for the radiofrequency ablation technique.
The only real side effect of the treatment is possible soreness where the needles were placed. That discomfort will subside in 24 to 48 hours.
Genicular nerve ablation is considered a low-risk procedure. However, it is not meant as a replacement for knee surgery when such surgery is appropriate, as the nerve-blocking procedure does not fix anatomical issues involved in knee stability or range of motion.
Genicular nerve ablation should come as welcome news to those struggling with chronic knee pain. The same technology has been used for decades for individuals with chronic lower back pain or neck pain.
Speak with your doctor to find a pain specialist who is trained to review the best options available for your particular situation—and hopefully you will be moving better and feeling better before you know it.
Alexander J. Chen M.D. is a physician with the Mid-Atlantic Permanente Medical Group in the Washington, D.C., area. He completed his post-graduate training at the Hospital of the University of Pennsylvania and Harvard-affiliated Beth Israel Deaconess Medical Center and is double board-certified in pain management and anesthesiology. Dr. Chen sees patients in the Kaiser Permanente Kensington and Largo Medical Centers.
